Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Institut National de la Santé et de la Recherche Médicale (INSERM), Unité Mixte de Service 011 Population-based Cohorts Unit, France (P.B., S.K., M.G., M.Z., E.W.).
Assistance Publique des Hopitaux de Paris Hôpital Bichat, Service de Physiologie Explorations Fonctionnelles, Paris, France (P.B., E.V.-P., J.F., M.-P.O.).
Hypertension. 2024 Nov;81(11):2286-2297. doi: 10.1161/HYPERTENSIONAHA.124.23007. Epub 2024 Sep 4.
There is a strong association between obstructive sleep apnea and hypertension, but the effects of obstructive sleep apnea symptoms on the risk of incident hypertension are not well documented. The aim of this prospective study was to examine whether snoring and sleepiness are associated with incident hypertension.
Data from the French population-based CONSTANCES cohort were analyzed. Normotensive participants, aged 18 to 69 years, were included between 2012 and 2016 and screened for snoring, morning fatigue, and daytime sleepiness in 2017 using items of the Berlin Questionnaire. We used Cox models, adjusted for multiple potential confounders, including body mass index, baseline blood pressure, sleep duration, and depressive symptoms, to compute hazards ratios of incidentally treated hypertension.
Among 34 727 subjects, the prevalence of self-reported habitual snoring, morning fatigue, and excessive daytime sleepiness (≥3× a week for each) was 23.6%, 16.6%, and 19.1%, respectively. During a median follow-up of 3.1 years (interquartile range, 3.0-3.5), the incidence of treated hypertension was 3.8%. The risk of de novo treated hypertension was higher in participants who reported habitual snoring (adjusted hazard ratio, 1.17 [95% CI, 1.03-1.32]) and excessive daytime sleepiness (adjusted hazard ratio, 1.42 [95% CI, 1.24-1.62]), and increased with the weekly frequency of symptoms, with a dose-dependent relationship (≤0.02 for all symptoms).
Self-reported snoring and excessive daytime sleepiness are associated with an increased risk of developing hypertension. Identification of snoring and daytime sleepiness may be a useful public health screening tool in primary care for hypertension prevention.
阻塞性睡眠呼吸暂停与高血压之间存在很强的关联，但阻塞性睡眠呼吸暂停症状对新发高血压风险的影响尚未得到充分记录。本前瞻性研究旨在探讨打鼾和嗜睡是否与新发高血压有关。
对法国基于人群的 CONSTANCES 队列进行了数据分析。纳入了年龄在 18 至 69 岁之间的血压正常的参与者，并于 2012 年至 2016 年期间进行了筛选，在 2017 年使用柏林问卷的项目对打鼾、早晨疲劳和白天嗜睡进行了筛查。我们使用 Cox 模型，调整了多个潜在的混杂因素，包括体重指数、基线血压、睡眠时间和抑郁症状，以计算新诊断高血压的治疗风险比。
在 34727 名受试者中，习惯性打鼾、早晨疲劳和白天过度嗜睡（每周≥3 次）的患病率分别为 23.6%、16.6%和 19.1%。在中位数为 3.1 年（四分位距，3.0-3.5）的随访期间，治疗性高血压的发病率为 3.8%。报告习惯性打鼾（调整后的危险比，1.17 [95%可信区间，1.03-1.32]）和白天过度嗜睡（调整后的危险比，1.42 [95%可信区间，1.24-1.62]）的参与者发生新发高血压的风险更高，并且随着症状的每周频率而增加，呈剂量依赖性关系（所有症状的 P 值均＜0.02）。
自我报告的打鼾和白天过度嗜睡与高血压风险增加有关。识别打鼾和白天嗜睡可能是初级保健中预防高血压的一种有用的公共卫生筛查工具。
